ABSTRACT
Background: Globally and especially in the under developing nations Postpartum Hemorrhage (PPH) is the most common cause of maternal mortality. All women who deliver are at risk of complications of third stage of labor. Multiple researches have been done to compare active vs expectant management of third stage of labor. Placental Cord Drainage (PCD), one of the active method for control of third stage of labor, incudes opening of clamp from mother’s side of umbilical cord thereby allowing the blood from placenta to flow freely immediately after clamping and cutting of the umbilical cord. Aim: Thus, the following study was conducted to assess the effect of PCD via umbilical cord in decreasing the time period of third stage of labor and incidence of PPH. Materials and Methods: This hospital based comparative study was conducted in the department of Obstetrics and Gynecology, National Institute of Medical Sciences & Research, Jaipur. A total of 300 consecutive patients with term pregnancy (>37 weeks) fulfilling the inclusion criteria were taken after informed consent. These were divided into two groups of 150 cases each, study group (PCD group) and control group. The various parameters like blood loss, need for transfusion, duration of third stage of labor, manual removal of placenta, hospital stay, secondary PPH (after 24 hours and before 6 weeks) were noted for every female. Statistical analysis was done using t-test for quantitative data, nonparametric data was analyzed by Mann Whitney test and categorical data was analyzed using chisquare test. The significance threshold of p-value was set at <0.05. All analysis was carried out by using SPSS software version 21. Results: Average blood loss was significantly less in subjects of drainage group as compared to control group (273.8 ml vs 391.2 ml; p<0.05). Also, average duration of third stage of labor was significantly less in drainage group (4.1 vs 7.7 mins; p<0.05). No difference was observed between two groups based on placenta weight (p-0.121). Conclusion: In the present study, PCD had a beneficial effect on the duration of third stage of labor and on postpartum blood loss. Thus, use of PCD is recommended in active management of labor by trained professionals
ABSTRACT
Background: : The quest to improve diagnostic and therapeutic capabilities has led to the widespread acceptance of modern gynaecological endoscopy. Hysterolaparoscopy is a basic skill in the advanced scientific era and an effective and safe tool in comprehensive evaluation of infertility with an added advantage of treatment of some pathologies in same sitting. Methods: This clinical study is a prospective study of 100 selected cases of infertility. Patients who fulfills the inclusion and exclusion criteria were subjected to diagnostic laparoscopy and hysteroscopy in NIMS Infertility and Research centre, Jaipur over a period of one and half years from Jan 2014 – June 2015. Observation of pelvic and intrauterine cavity and chromopertubation test was done under general anaesthesia during hysterolaparoscopy. Surgical interventions were carried out whenever required and further treatment plan was decided. Results: A total of 100 women underwent hysterolaparoscopy. Age ranged from 21 to 40 years and mean age was 30.03 years. Prevalence of primary infertility was 64% and of secondary infertility was 36%. Among cases with primary infertility commonest pathology responsible were ovarian 20 (31.25%) followed by unexplained 19 (29.69%), uterine 11 (17.18%), tubal 8 (12.50%) and peritoneal 8 (12.50%) whereas in secondary infertility commonest pathology responsible were uterine 14 (38.88%), followed by tubal 13 (36.11%), peritoneal 9 (25%), ovarian 8 (22.22%) and unexplained being the least 2(5.55%). Therapeutic procedures were performed in the same sitting amongst 84.61% cases with primary infertility and 92% cases with secondary infertility.Conclusion: When done by experienced hands, with proper selection of patients, hysterolaparoscopy is an indispensable tool which can be considered as a definitive day care procedure for evaluation and treatment of female infertility.
ABSTRACT
Background: Low progesterone levels have been linked to increased risk of miscarriage in first trimester of pregnancy. Methods: The observational, cross-sectional study was conducted over 100 pregnant females in first trimester of pregnancy < 12 weeks. All patients were subjected to sonography to confirm pregnancy & serum progesterone level testing immediately after admission and before initiation of treatment. Result: After analysis of the results, cut off value of serum progesterone as determined in this study came out to be 9.9 ng/ml with 94.9% sensitivity & 92.7% specificity. Conclusion: The value of serum progesterone estimation was of great help in differentiating between viable and non-viable pregnancy.
ABSTRACT
Background: The present study was planned to assess the role of uterine artery Doppler in the prediction of IUGR and Pre-eclampsia in the department of obstetrics and Gynaecology at NIMS Medical College during a span of one year (Nov 2013-Oct 2014). Methods: One hundred pregnant women with singleton pregnancy at 18-20 weeks period of gestation were subjected to uterine artery Doppler study and later repeated at 24-26 weeks of gestation. Results: It was observed that 38% patients had abnormal outcome with 20% patients with IUGR , 12% with PE, 6% with both IUGR and PE. Conclusion: By inclusion of uterine artery Doppler study in routine practice and timely intervention fetomaternal morbity and mortality can be greatly reduced.
ABSTRACT
Background: The Objectives of the present study are to assess the risk factors associated with antepartum haemorrhage (APH), maternal morbidity & mortality due to APH and its perinatal outcome in APH. Methods: This study was an analytical retrospective study conducted at NIMS University and Medical College, Jaipur over the duration of one year from July 2013-July 2014 over 100 cases of APH admitted in the hospital. Results: Among the 100 cases of APH the types observed were, placenta praevia: 39, abruptio placenta: 31, indeterminate causes: 25 and extra placental causes: 5. Maternal mortality out of 39 cases of placenta praevia was 1 and out of 31 cases of abruptio placentae was again 1. Perinatal mortality was 10% in placenta praevia and 19% in abruptio placentae. Conclusipn: APH is a major cause of maternal and perinatal mortality & morbidity, which can be prevented, by early registration, regular antenatal care, early detection of high-risk cases, early referral, better blood bank and OT facilities, improved intra-operative and postoperative care and better neonatal intensive care.